[bigphil]

I broke my collar bone this morning with a swan dive over the back of a car.  I was flying to France for a weeks riding in the Alps on Wednesday but no longer.  Anyone got any tips for not aggravating the break and not going stir crazy over the summer whilst not able to do anything?  Would like this enforced lay off to result in something productive.

Phil

[GCW]

I'm assuming it's undisplaced and doesn't need fixing?

I'm sure Bubbs will have some input.

[bigphil]

I'm not sure what undisplaced is but its a central clean break thats left me with a bump in the middle and a lot of pain.  A&E gave me a sling and some painkillers and thats my lot at the moment.

[Bubba]

I'm sure Bubbs will have some input.

I feel your pain, I did the same thing on my mobike.

I suspect a sling & painkillers is all you're going to get.

Not a lot you can do really but wait for a long long time and try not to use it as much as possible. You won't need tips, it'll be obvious when you're aggravating it coz it'll hurt!

Mine took about a decade to get to a point where it didn't ache/move about/etc anymore. Hopefully yours won't take as long!

[SA Chris]

Bummer Phil. Gues we won't be having that pint in Les Gets next weekend then. No advice I'm afraid, other than wishing you a speedy recovery.

[Nibile]

i broke my left collar bone hitting a street lamp with my bike many many years ago. mine was a bad fracture, with displacement and fragmented borders, but after some time went fine, apart from being awful to see and strange when some kinds of clothes are on it. or the safebelt also.
i did nothing particular apart from trying to articulate the shoulder after a couple of weeks with the sling.
get well soon.

[Bubba]

I seem to remember it took me about 3 to 4 weeks before I could do anything much with the arm.

I also had the most amazing bruise from the break: yellow, blue, purple, black - it was ugle but lovely at the same time.

[BB]

I did mine in Les Gets a couple of seasons ago and the French gave me an awesome sling crossed over behind my back pulling my shoulders back, helping the bones to settle in a less bumpy and lumpy manor. Worth looking into to see if you can get something a bit more clever than a triangular bandage.

This is it...

[bigphil]

Bummer Phil. Gues we won't be having that pint in Les Gets next weekend then. No advice I'm afraid, other than wishing you a speedy recovery.

Yeah sorry Chris I was really looking forward to both the ride and that pint. Maybe another time.

I might look into that figure of 8 bandage. It looks more effective then the sling I have now.

[GCW]

There's no good evidence to show that the fugure of 8 bandages are superior to the broad arm sling, either for pain ot healing.
I assume you have a fracture clinic appointment- ask the junior that you will no doubt see, and assess how confused they look

[bigphil]

Fracture clinic appointment is tomorrow so will no doubt get more info then.  I'm just keen for the long term stability and strength of the fracture to be maximised so don't want to do anything that will joepardise future mobility.

[slackline]

Anyone got any tips for not aggravating the break and not going stir crazy over the summer whilst not able to do anything?

Masturbate with the other hand 

[fatdoc]

I did mine in Les Gets a couple of seasons ago and the French gave me an awesome sling crossed over behind my back pulling my shoulders back, helping the bones to settle in a less bumpy and lumpy manor. Worth looking into to see if you can get something a bit more clever than a triangular bandage.

This is it...

a lot of peeps doo say figure of eights help with pain early on... no good trials that I know of....


I'd have one..

[Fiend]

I broke my collar bone years ago....bloody mountain biking of all things, stupid activity 

Anyway. I wore the fig 8 thing, definitely felt effective. As far as I can remember, the break healed in a pretty normal timescale (within 3 months) and I was back to full strength/usage in a pretty normal timescale (within 6 months). There were no problems afterwards (although it's had a slight long term effect on my shoulder but we're talking really slight).

Just look after it like a normal break and it should be cool.

[webbo]

i bust mine a few years ago mountain biking.it was just before the start of the race season and as i'd trained like a bastard all winter i was gutted.however as soon as i could walk without any major discomfort,thats what i did building up to about 15 miles.then when i could get on the turbo without the missus catching me.i started doing  20 mins steady the gradually building it up.i think i was out riding on the road within 5 weeks.

[bigphil]

The Dr. in yesterdays fracture clinic thought I'd done it mountain biking and that's what I normally so. I guess it would have happened one way or another and sooner or later. I guess i was pretty lucky given that there was a guy in there who'd done the same thing as me but who was now paralised from the chest down.

 

[bigd942]

if you can, get it pinned, sometime do it if your a bricklayer etc and your living depends on it they'll do it depending on how bad it is, at least thats what I was told once, not sure if its true. All the pro cyclists get them pinned straight away, didn't realise the cut was so big though!

[Bubba]

They told me that they wouldn't do it unless I was a woman (obviously didn't know about my penchant for wearing strapless dresses, sigh!) and muttered about it being a nasty operation with blood vessels all over the shop.

So mine ended up with a nasty bump and one shoulder sits very slightly differently to the other.

Perhaps the NHS are a little more enlightened now?

[GCW]

You need to be very selective which ones you fix, for most the functional outcome is the same so it isn't worth the operative risk.
Ones that are very displaced, or of the lateral 1/3 are more likely to be operated upon.

It's certainly not a benign operation and I personally wouldn't rush into it just for the sake of it.

[webbo]

however i have heard of cyclists needing to have it rebroken then pinned at a later date when this wasn't done at the time of the original break.it can effect your riding postion if one shoulder is lower than the other.also it can lead ones better half using as yet more indications of ones decrepitude.

[fatkid2000]

Looks like the usual orthopaedic scenario: One fracture - 10 surgeons - 10 opnions on management. I would agree with GCW. When I gassed my most hair raising (i.e shitting ones pants) anaesthetics were shoulder ops on fit and healthy people so IMHO not something to be entered into lightly, especially if there is no difference in functional outcome. From my very basic orthopaedic knowledge UK surgeons seem pretty conservative and very picky about those they repair, compared to the Europeans - as I have gassed 2 cases where metal work has been removed from clavicles due to causing a whole heap of problems, having been repaired in certain French ski resorts.  Fatdoc tells a tale about a shoulder operation on a colleague as well.

[jfw]

I broke my collar bone and the spine of shoulder blade by landing from a great height on the point of my shoulder mountain biking - here are my top tips

1) While supporting your elbow with your good hand (to keep the break immobile) - open out your elbow to straighten your elbow and straighten out your affected arm (this helps stop the tendons in your arm shortening  which can happen if you wear a sling non-stop - may not be as relevant to straightforward/quicker healing breaks).

2) Remember that being tired/resting is sometimes part of your body rebuilding.

3) when you are going crazy from not doing any exercise - get to a gym and get on a recumbant/ sitting down static bike (with your legs in front of you) - as you can do this before you can necessarily even manage the turbo.

[GCW]

for most the functional outcome is the same

Certain fractures I always fixed if the patients were keen.
Most middle 1/3 fractures heel very well, and functional outcome is the same.  If it's the look of it that's an issue, a metal plate may look just as bad, and often gives pain/tenderness when wearing a rucksack etc.  The scar can also be permanently tender.  Taking the plate out is possible, but it's often buried and it's not uncommon to re-fracture the clavicle getting them out again.
I loved plating clavicles, great fun- but you need to be aware of the clockwork that's within an inch of your drill.

however i have heard of cyclists needing to have it rebroken then pinned at a later date when this wasn't done at the time of the original break

The clavicle is an interesting bone, one of a couple that arise from intramembranous ossification, and is prone to delayed/non-union.  Even with ORIF there's a proportion that still don't heal, and need re-do or even re-re-do.  So, just because you cycle doesn't automatically mean fixation is best.

It's all very dependant on your patient, the fracture configuration, and you need to get an agreement with the patient.

[rginns]

for most the functional outcome is the same

The clavicle is an interesting bone,

geek 

[bigphil]

There are a lot of big words there GCW but I get the overall gist.  Fracture clinic doctor said that he had no worries about it healing OK.  The bone is broken in the centre and the two ends have caught on each other during the break so they are still touching.  I've got a sling but I'm not wearing it all the time as I'm keen to keep the shoulder moving within the pain limits so that it doesn't freeze.  I'm not lifting or doing too much with it, just letting it mover.  So far so good.  A bruise is starting to come out but nothing major yet but I'd rather not have an op and just see how it goes.

P

[GCW]

The bone is broken in the centre and the two ends have caught on each other during the break so they are still touching. 

Most middle 1/3 fractures heel very well, and functional outcome is the same.

Good luck.

[fatdoc]

You need to be very selective which ones you fix, for most the functional outcome is the same so it isn't worth the operative risk.
Ones that are very displaced, or of the lateral 1/3 are more likely to be operated upon.

It's certainly not a benign operation and I personally wouldn't rush into it just for the sake of it.

shoulder anaesthesia is one of my duties... I work with a very respected and able surgeon.. as above - it's not done without some real risk..

[bigphil]

After what seemed like the start of a good recovery I had a very painful night and it feels like the bones have moved. I'm no longer certain that they are touching end to end and they might now be overlapping slightly. Does anyone know if that is a serious issue in terms of long term recovery? 

[GCW]

Nah, they will shift about initially and it'll hurt but it should be OK long term.  They'll check it in clinic anyway, but I wouldn't worry.

[bigphil]

Thats just what i wanted to read GCW.  Ta

[SA Chris]

The weather was awful and my mates who did the passportes sad it was crap and they hated every minute.

(some of the above facts are untrue, but I am trying to ease the pain)

What's the diagnosis?